Bilateral orbital cellulitis: A case report and management challenges

Abstract

To report a case of bilateral orbital cellulitis in a conscious 11-year-old Nigerian girl and the management challenges. Bilateral orbital cellulitis secondary to rhinosinusitis is uncommon but has been reported in the literature in other countries where the diagnosis was made with the aid of necessary tools such as the computerized tomography scan among others. In this case, the challenge associated with the management of the index child is a reflection of the difficulties encountered in the treatment of patients in the developing countries and the importance of a good clinical judgment, early diagnosis, and prompt intervention in the management of bilateral orbital cellulitis. This is a case report of an 11-year old Nigerian girl of the Igbo tribe. She presented with painful progressive protrusion of the eyeballs and swelling of the lids of 3 days duration. The left eyeball protruded 2 days after the right with no associated history of altered sensorium. A working diagnosis of bilateral orbital cellulitis secondary to rhinosinusitis was made. She was placed on parenteral and topical antibiotics until she recovered. Bilateral orbital cellulitis occurring in a conscious child is uncommon. Prompt and specific treatment should be started empirically, especially in developing countries where the facilities for investigation may not be available or the patients may be financially handicapped. This is particularly important to prevent the possible loss of vision and severe life-threatening complications. This study will be of interest particularly to the ophthalmologists, the otorhinolaryngologists, and the pediatricians.

Keywords: Bilateral, conscious, management challenges, orbital cellulitis